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New Affiliate Signup !

Please complete the form below to become an affiliate at SkillHead.com.
Items marked with * are required.

• Affiliate Partner Account Information:

Select Affiliate Partner ID*

Password will be forwarded to email address on file.

Email Address*

Confirm Address*

• Website Information:

Website Name* (ex. SkillHead Tournaments)

Site URL*

Please provide a short description of site*

How many unique visitors does your site receive every month*

The approximate number of members/clients your website has

Does your website*

Require a login?	YES NO
Offer rewards/compensation?	YES NO
Send out a Newsletter?	YES NO
Donate a portion of its proceeds to an organization?	YES NO

Your intended method of promotion. ( Check all that apply) *

Email/Newsletter Website/content Software Search engine Offline

What country represents the majority of your site's users*

• Payment Information:

Select which method you would like to use for receiving your payments*

If paypal provide paypal email account to use, or Check - If Check payable to who? *

First Name*

Last Name*

Street Address*

City*

State*

ZIP/ Postal Code*

Country*

Phone*

Fax

Tax ID(SSN/EIN) - Required for U.S. publishers*

If your commissions will be over $600, we will need to send you tax forms. Therefore, we need the following information:

Tax Classification

• Affiliates/Partners Terms and Conditions Agreement:

I have read, understand and agree to the terms and conditions